Long term use of topical & systemic steroids produce secondary open angle glaucoma similar to chronic simple glaucoma. The increased IOP caused by prolonged steroid therapy is reversible but the damage produced by it is irreversible. In this study, we analysed 25 patients (44 eyes) with steroid induced glaucoma, who reported to us with dimness of vision, haloes and elevated I.O.P. and were using steroids for long duration due to various causes. The behaviour of the I.O.P. due to different steroid preparations, the type of lenticular change, and the management of those cases are discussed in this paper. From our study we conclude that dexamethasone and betamethasone both topical as well as systemic are more potent in producing glaucoma and cataract than medrysone and prednisolone. The condition is reversible without permanent damage when the duration of steroid therapy is short and vice versa.

The effects of long term wear of PMMA contact lenses on the corneal endothelium used on a daily wear basis were determined by examining 8 patients who had been prescribed lenses in one eye only. The patients excluded unilateral aphakes. It was found that a significant reduction in the cell density and a change in the cell size and shape was induced by PMMA lenses. These changes reflect an endothelial metabolic stress and emphasize the need to find newer lens materials that are more oxygen permeable and produce little interference with the corneal metabolism.

A case report of myopic myositis, a rare entity, leading to strabismus fixus convergens, occurring in a high myope at the age of 46 years is presented. The possible differential diagnosis along with the aetiopathogenesis is discussed.

Thirty five patients with insulin dependent diabetes mellitus (IDDM) were investigated for development of retinal microangiopathy by fluorescein angiography. HLA typing (A,B.C antigens) was done as a genetic marker. There was no statistically significant difference in the frequency of HLA antigens between patients without retinopathy (Gr.I) and with retinopathy (Gr.II) Frequency of various HLA antigens did not differ significantly in the mild and severe retinopathy groups or in comparison with controls. HLA B8 was significantly over represented in the patients of IDDM as a single group (GrI + II) when compared with controls (26% vs 8%). HLA profile was not a predictor of either the development or the severity of retinopathy in IDDM.

An unusual case of cyclic pupillary movements in an otherwise complete oculomotor nerve palsy in a five year-old girl is reported. This is considered to be due to destruction of somatic and visceral nuclei of the oculomotor nerve following injury to its fascicular part. Pupillary automatism has been explained on the basis of the presence of aberrant autonomic cells in the ciliary ganglion which are discharging in a regular rhythm independent of higher control.

A rare case of congenital bilateral ectopia lentis et pupillae (ELEP) is reported in a 32 year old female presenting with complaints of diminution of vision in both eyes. Associations of optic nerve hypoplasia and myelinated nerve fibers are being reported for the first time in such a case. The aetiopathogenesis of ELEP is controversial. Combined neuroectodermal and mesodermal origin is being postulated for this syndrome on the basis of aforesaid abnormalities and presence of pupillary dilator muscle hypoplasia, "annular endotheliopathy", and persistent pupillary membrane in both eyes.

In Ophthalmic practice diazepam is often used a a premedicant. We report a case where administration of diazepam led to a state of acute delirium because of which surgery had to be postponed. The possible mechanisms for this reaction and the treatment is discussed. This side effect of diazepam should be kept in mind while dealing with delirium in the geriatric age group.

Estimation of retinoblastoma antigen by double antibody sandwich ELISA technique was carried out in 20 histopathologically confirmed cases of retinoblastoma, 20 cases of pseudoglioma and 20 normal cases. The method of detection was done on the lines of Voller et al. (1976) with slight modification. The number of seropositive cases was more in cases with retinoblastoma.

Growth hormone has been considered to be the cause of diabetic retinopathy. However the relationship between growth hormone responses and diabetic retinopathy has not been consistent. Moreover, the correlation (if any) between the severity of retinopathy and growth hormone changes are also not well defined. In the present study 23 diabetics (16 with retinopathy, 7 without retinopathy) and 8 non-diabetic healthy controls were studied. Serum growth hormone was measured in the fasting state and one hour after levodopa administration. The mean growth hormone levels were significantly higher in the diabetics as compared to controls, however there was no correlation between the mean growth hormone levels (either in the fasting state or after levodopa stimulation) and presence or absence of diabetic retinopathy although diabetics with retinopathy had significantly greater mean growth hormone response. The mean growth hormone was found to have no correlation with the fasting blood sugar levels. Diabetics with back ground retinopathy had significantly greater mean growth hormone levels than those with proliferative retinal changes

In the present study 60 diabetics were examined for intraocular pressure, scleral rigidity and facility of outflow. The intraocular pressure was found higher than in the general population except in patients with proliferative retinopathy. There was no marked difference in scleral rigidity in diabetics. The facility of outflow was lower in diabetic patients.

The practice of pre-operative 'Test Patch' on any eye continues to be an important, conventional step at a number of eye infirmaries. The present study was carried out on eighty seven eyes to determine the relevance of Test Patch as a prelude to surgery. After a critical analysis of the result of investigation, it is concluded that the 'Test Patch' does not provide a statistically reliable information regarding potential bacterial infection since there is no correlation between pre-patching and post-patching clinical appearance, and bacterial isolates in a given case. Presence of polymorphs or organisms in the Grams stained conjunctival smears did not make any difference with regard to a positive or negative bacterial growth in a given eye. It is concluded that 'Test Patch' neither predicts nor helps in any way in a case waiting to undergo intra ocular surgery. The Test Patch, therefore, at best, can serve as an acclimatizing exercise that simulates bandaging in the post-operative period.